Because at a certain point, it’s more than PMS.
Welcome to BuzzFeed’s Mental Health Q&A, where we consult with experts to answer your biggest mental health questions. Have a question about mental or emotional health, happiness, relationships, stress, or anything else? Hit us up at MentalHealthQs@buzzfeed.com.
This week’s question: Why do I get more depressed before my period?
I was diagnosed with major depression a couple of years ago, and while I'm still working it out, I have it pretty much under control right now. Without fail, however, crushing sadness/apathy/emotional numbness or a combination of those greet me about three days before my period starts.
At what point does this cease to be normal PMS and become something that maybe can or should be treated? Who should I talk to about this?
Hey Anonymous! So, full disclosure, right off the bat: You'll have to see a doctor to know for sure what's going on with you specifically.
In the meantime, we talked to Dr. Catherine Birndorf, clinical associate professor of psychiatry and obstetrics and gynecology at Weill Cornell Medical Center and Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology at Yale School of Medicine, about the relationship between your period and depression. Here's what they had to say:
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Being sad, moody, or irritable is a pretty typical symptom of PMS — but when it affects your ability to function, it’s probably something more.
“Functional impairment” — meaning when something gets in the way of your day-to-day life — is where experts draw the line between typical negative emotions and an actual disorder. We'll get to what those disorders might be in a second, but there are a few questions you can ask to know if something more serious is going on than regular PMS.
“Have you missed work or school?” says Birndorf. “Do you stay home a day or two a month because you're so miserable with these symptoms? Is it, 'I'm sad and moody and don't want to leave the house' or is it, 'I'm so miserable or angry or depressed that I can't?'”
And if that sounds like you, that's when it's time to talk to a doctor. When you do, these are the things they'll probably go over with you:
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It could be Premenstrual Dysphoric Disorder (PMDD), a disorder that causes severe depression symptoms before your period.
In the simplest terms, PMDD is really bad PMS. According to the DMS-5, to be diagnosed, you have to have five of the following symptoms (and at least one of the first four):
- Sudden mood swings
- Irritability, anger, or increased conflict with others
- Depressed mood or feelings of hopelessness
- Anxiety or tension
- Decreased interest in usual activities
- Difficulty staying focused in attention or thinking
- Change in appetite, or food cravings
- Trouble sleeping or sleeping more than usual
- Feeling overwhelmed or out of control
- Physical symptoms, such as breast tenderness, joint or muscle pain, weight gain, or bloating
What's also important here is that your symptoms are cyclical, says Minkin — AKA most of the month you're completely fine, then anywhere from a few days to two weeks before your period (everyone's different), the symptoms set in. And then once you start your period, they lessen and go away. Rinse and repeat.